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Monday, 17 July 2017

Politics: The Republican healthcare bill is on the edge of failure

The Better Care Reconciliation Act is facing a weeklong delay, and that may not be a good thing.

A planned vote on the Senate healthcare bill has been delayed at least a week by Majority Leader Mitch McConnell after Sen. John McCain underwent surgery Saturday and told leaders he would remain in Arizona for the week to recuperate.

Two GOP lawmakers — Sens. Rand Paul of Kentucky and Susan Collins of Maine — have already publicly said they will not support the bill, named the Better Care Reconciliation Act.

Paul and Collins' opposition combined with McCain's absence leaves McConnell short of the 50 votes needed to pass the bill.

Whether the delay will be a good or a bad thing for the bill is debatable.

On the one hand, it gives opponents of the BCRA more time to pressure moderate senators over the bill's Medicaid cuts and projected coverage losses. Given the razor's edge the bill sits on, it could be derailed if a flood of negative polls or analysis over the next week sways even a single senator.

No one wants to be the deciding vote to kill a bill, but if one member does publicly become the deciding vote, others may follow.

Among the complicating factors is Sen. Ron Johnson of Wisconsin. Johnson originally came out against the BCRA for not being conservative enough, but he said he was on board after the release of an updated version. Over the weekend, however, Johnson told the Green Bay Press-Gazette in Wisconsin that he was back to being undecided on the bill because of reports that McConnell told moderate Senate members that the bill's deep cuts to Medicaid would never take effect.

Another big issue for undecided lawmakers is the release of the Congressional Budget Office's score for the updated BCRA. The original score, which estimated that 22 million more Americans would be without health insurance in 2026 under the BCRA than under the current system, was a key point of contention for centrist Republicans who opposed the first iteration of the healthcare bill.

The new score was originally set to be released Monday, but, given the delay for the vote, it will also be pushed back. It's unclear when it will be released, but reports suggest it could be as late as next week.

It also gives more time for McConnell, who is known as an adept dealmaker, to work with individual senators to address their issues or create amendments to placate their particular concerns. Already, the bill includes multiple carveouts for certain states or issues particular senators care about.